An overload of policy recommendations is making it harder for nurses and other health professionals in England to deliver quality end of life care, according to a new report.
Written by Sheffield Hallam University, the State of the Nations report looked at policy on terminal illness in all four UK nations. It found 76 different government publications relating to the subject had been published in England since 2004.
“There are a large number of strategy and guidance documents in circulation”
This compares to just nine in Wales, 25 in Scotland and 12 in Northern Ireland, according to the research, which was funded by the charity Marie Curie.
The sheer number of recommendations and amount of information makes it difficult for healthcare commissioners and providers to understand and implement best practice, the report suggested.
Julie Skilbeck, a senior lecturer at the university and expert in palliative care nursing, said: “England’s palliative and end of life care policies are key drivers for commissioning, planning and delivering services for people living with terminal illness.
“However, there are a large number of strategy and guidance documents in circulation,” she said.
“This profusion is making it extremely difficult for commissioners and practitioners to develop and implement services for people requiring end of life care,” she warned.
The report, which calls for one clear piece of over-arching guidance for England, said the same “excess of information” was true of Scotland “to some extent”.
Meanwhile, it also highlighted a lack of clarity on funding and budgets for end of life care.
“There has been little action to drive quality of choice”
Its publication co-incides with the government’s response to the independent Review of Choice at the End of Life, which sets out a range of commitments and steps designed to improve services in England.
The Sheffield Hallam report also comes alongside a new analysis by Marie Curie that shows the proportion of deaths in England from conditions needing palliative care, including Alzheimer’s disease and dementia, are rising rapidly.
The analysis of mortality data from 2012 to 2014 found more than seven out of 10 people die from a condition that needs palliative care.
However, this could be as many as nine out of 10 if other conditions that may have contributed to a person’s death are taken into account.
“This new data show us the need for palliative care is continuing to increase as people die with more complex needs and conditions,” said Marie Curie chief executive Dr Jane Collins.
“However, the Sheffield Hallam report highlights there has been little action to drive quality of choice from the government, despite a wealth of announcements and documents aimed at tackling this crucial issue.”
In addition, the report noted that England, Scotland and Wales at least had up-to-date end of life care strategies with established goals, but suggested that this was not the case in Northern Ireland.
“It is fair to say that, despite an ongoing strategic programme of work to implement end of life care priorities, there is limited evidence of a current and overarching end of life care strategy in Northern Ireland,” it stated.